慢性心力衰竭不同心功能分级患者hs-cTnT与心肌纤维化指标变化  

Changes of hs-cTnT and myocardial fibrosis indexes in chronic heart failure patients with different cardiac function classes

作　　者：丁梦影 种莹 DING Meng-ying;CHONG Ying(Department of Laboratory Medicine,Huaibei Hospital of Traditional Chinese Medicine,Huaibei 235000,Anhui,China)

机构地区：[1]淮北市中医医院检验科,安徽淮北235000

出　　处：《川北医学院学报》2023年第2期245-248,共4页Journal of North Sichuan Medical College

摘　　要：目的:分析慢性心力衰竭(CHF)不同心功能分级患者超敏心肌肌钙蛋白T(hs-CTnT)与心肌纤维化(MF)指标[透明质酸(HA)、层粘蛋白(LN)、Ⅲ型前胶原(PCⅢ)]变化。方法:回顾性分析180例CHF患者临床资料,根据不同NYHA心功能分级分为Ⅱ级组(n=63)、Ⅲ级组(n=61)及Ⅳ级组(n=56),比较各组临床资料、心功能标志物与MF指标差异。结果:各组中,除Ⅳ级组年龄大于Ⅱ级组、Ⅲ级组(P<0.05),其余性别、吸烟史、饮酒史、原发疾病等指标比较,差异均无统计学意义(P>0.05)。各组收缩压、舒张压比较,差异无统计学意义(P>0.05);Ⅳ级组心率高于Ⅱ级组(P<0.05);6MWT:Ⅳ级组<Ⅲ级组<Ⅱ级组(P<0.05)。各组hs-cTnT、N末端B型利钠肽原(NT-ProBNP)、C反应蛋白(CRP)水平:Ⅳ级组>Ⅲ级组>Ⅱ级组(P<0.05)。各组HA、LN、PCIII水平:Ⅳ级组>Ⅲ级组>Ⅱ级组(P<0.05)。结论:CHF患者hs-cTnT与血清HA、LN、PCIII水平呈现随NYHA心功能分级增高而提升的趋势,提示该四项指标在评估CHF心功能受损程度方面具有一定的临床参考价值。Objective:To analyze the changes of high-sensitivity cardiac troponin T(hs-CTnT) and myocardial fibrosis(MF) indexes [hyaluronic acid(HA),laminin(LN),procollagen typeⅢ(PCⅢ)] in patients with chronic heart failure(CHF) with different cardiac function classes.Methods:The clinical data of 180 patients with CHF were retrospectively collected, and they were divided into grade Ⅱ group(n=63),grade Ⅲ group(n=61),and grade Ⅳ group(n=56) according to different New York Heart Association(NYHA) cardiac function classes.The differences in clinical data, cardiac function markers and MF indexes of the groups were compared.Results:The age of grade Ⅳ group was greater than that of grade Ⅱ and Ⅲ(P>0.05),and there was no statistical significance in gender, smoking history, drinking history and primary disease among the groups(P>0.05).There was no significant difference in systolic blood pressure and diastolic blood pressure among the groups(P>0.05).The heart rate of grade Ⅳ group was higher than that of grade Ⅱ group(P<0.05),6MWT:grade Ⅳ groupgroup Ⅲ>group II(P<0.05).The levels of HA,LN and PCⅢ in the groups: grade Ⅳ group>grade Ⅲ group>grade Ⅱ group(P<0.05).Conclusion:The levels of hs-cTnT and serum HA,LN,and PCⅢ in CHF patients showed a trend of increasing with the increase of NYHA cardiac function classification, suggesting that the four indexes have certain clinical reference value in assessing the degree of cardiac function impairment in CHF.

关 键 词：慢性心力衰竭 美国纽约心脏病协会心功能分级 超敏心肌肌钙蛋白T 透明质酸 层粘蛋白 Ⅲ型前胶原 

分 类 号：R541.6[医药卫生—心血管疾病]